• Journal of Korean Neurosurgical Society
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• v.30 no.4
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• pp.518-521
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• 2001

We present a rare case of a pituitary adenoma revealing a sedimentation level on MRI, which has not been previously documented. This 55-year-old woman was referred with the diagnosis of craniopharyngioma. She presented with four-month history of progressive headache and visual dimness. Neurological examination revealed a bitemporal hemianopsia and decreased visual acuity. Laboratory data including endocrine examination were unremarkable. An additional three-dimensional MRI was taken for further evaluation, and demonstrated a sedimentation level within the tumor. The patient underwent transcranial removal of the tumor. About 12cc of dark-red blood was aspirated from the tumor. Histological examination revealed a pituitary adenoma with hemorrhage. Postoperatively, the patient showed gradual improvement of visual function. Considering that the pituitary adenoma is one of more common tumors that cause tumoral bleeding, a cystic sellar tumor that has a sedimentation level should be sought first for a pituitary adenoma rather than a craniopharyngioma. This may have an important impact when deciding surgical approach.

• Clinical and Experimental Pediatrics
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• v.62 no.3
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• pp.108-112
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• 2019

Subacute sclerosing panencephalitis (SSPE) is a rare, progressive, and fatal central nervous system disorder resulting from persistent measles virus infection. Long-term data are scarce, with a maximum follow-up period of 10 years. Interferon-alpha ($IFN-{\alpha}$) is a protein that exerts its antiviral activity via enhancement of cellular immune response and is reported to be an effective drug for the treatment of SSPE. However, there is currently no consensus regarding the optimal duration of $IFN-{\alpha}$ therapy. Here, we present a case report of a patient with SSPE treated with long-term intraventricular $IFN-{\alpha}$ therapy, which facilitated clinical improvement and neurological stabilization without causing serious adverse effects. To the best of our knowledge, this is one of the longest follow-up studies investigating a patient with SSPE receiving intraventricular $IFN-{\alpha}$ treatment. Further studies are necessary to validate the benefits and safety of long-term intraventricular $IFN-{\alpha}$ treatment in patients with SSPE.

• Journal of agricultural medicine and community health
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• v.24 no.2
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• pp.315-329
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• 1999

Recently, dissatisfaction with aspects of health care has been complemented by directly at complaints such as informal, formal and litigation. But some people take action and other not in spite of feeling of dissatisfaction. This study was to investigate an accounts of patient's disagreement with doctor's care from a community sample, and make a distinction between felt disagreement and disagreement actions. This study was done in six hundred forty residents in Sungjoo County of Kyungbuk Province and Nonman city of Chungnam Province. The questionnaires of interview included sociodemographic data, health status data, a nature of patient's disagreement with doctor and actions taken following or during the disagreement episode. Approximately sixteen percent of sample reported a disagreement, and nine percent reported action taken following or during the disagreement episode. Age, educational attainment, income and area were significantly related with experience of disagreement episode in univariate analysis. In people who experienced the disagreement episode, nearly forty-one percent reported on disagreement about the diagnosis related, twenty-eight percent reported doctor-patients relationship related, twenty percent reported treatment related, and eleven percent reported prescription drug related. In people who experienced actions taken following or during the disagreement episode, nearly fifty-four percent acted as 'sought a second opinion or visit other doctor', thirty-six percent acted as 'verbally challenged the doctor', thirty-two percent acted as 'stopped prescribed treatment or medication', twenty-nine percent acted as 'made repeat visits to the same doctor', twenty-five percent acted as 'eventually left and changed doctor'. Results of multivariate analysis, age, marital status, have or haven't chronic disease, and general satisfaction with health service were significantly related with experience of disagreement episode and marital status was significantly related with experience of actions taken following or during the disagreement episode. This study is experimental and exploratory trial about a relationship between patient's disagreement with doctor and actions taken following or during the disagreement episode in some community of Korea. We find that patient's disagreement with doctor and actions taken following or during the disagreement episode is latent in our community. We suggest that the relationship between felt disagreement and disagreement action is more complicated and worthy of further study.

• International Journal of Computer Science & Network Security
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• v.24 no.8
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• pp.32-42
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• 2024

The Internet of Things (IoT) is set to transform patient care by enhancing data collection, analysis, and management through medical sensors and wearable devices. However, the convergence of IoT device vulnerabilities and the sensitivity of healthcare data raises significant data integrity and privacy concerns. In response, this research introduces the Smart-Coord system, a practical and affordable solution for securing healthcare IoT. Smart-Coord leverages blockchain technology and coordinate-based access management to fortify healthcare IoT. It employs IPFS for immutable data storage and intelligent Solidity Ethereum contracts for data integrity and confidentiality, creating a hierarchical, AES-CBC-secured data transmission protocol from IoT devices to blockchain repositories. Our technique uses a unique coordinate system to embed confidentiality and integrity regulations into a single access control model, dictating data access and transfer based on subject-object pairings in a coordinate plane. This dual enforcement technique governs and secures the flow of healthcare IoT information. With its implementation on the Matic network, the Smart-Coord system's computational efficiency and cost-effectiveness are unparalleled. Smart-Coord boasts significantly lower transaction costs and data operation processing times than other blockchain networks, making it a practical and affordable solution. Smart-Coord holds the promise of enhancing IoT-based healthcare system security by managing sensitive health data in a scalable, efficient, and secure manner. The Smart-Coord framework heralds a new era in healthcare IoT adoption, expertly managing data integrity, confidentiality, and accessibility to ensure a secure, reliable digital environment for patient data management.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.7
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• pp.564-572
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• 2016

This study investigated the factors affecting the safety care activities of 227 nurses in 7 small and medium-sized hospitals in G-city. Data were collected from May 16th to 23rd, 2016, and analyzed using descriptive statistics, the t-test, one-way ANOVA, Pearson's correlation, and multiple regression with SPSS 18. The levels of patient safety attitudes, safety control and safety care activities were 4.11, 3.74 and 4.33 out of 5, respectively. In the analysis of the patient safety attitudes, there were significant differences in education level and job satisfaction. In the analysis of safety control, there were significant differences in age, education level, working experience, position, experience of safety education, experience of safety accidents, and job satisfaction. In the analysis of the safety care activities, significant differences were found in the education level, work department, experience of safety education, and job satisfaction. The patient safety attitudes, safety control, and safety care activities were positively correlated (with each other). The major factor affecting the safety care activities was the patient safety attitude, followed by safety control and experience of safety education. These findings emphasize the need for nurses to change their perception of patient safety attitudes and safety control, in order to reinforce their safety care activities. They also suggest that various safety nursing cases and systematic support should be provided for continuous patient safety education.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.8
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• pp.5458-5467
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• 2015

This study is descriptive research to investigate level of the attitude of patient safety and patient safety management activity(PSMA) and identify influencing factors of PSMA in nursing students. The participants were 241 4th grade nursing students who had clinical practice over a year from 3 nursing colleges in G city and J province. Data were collected with structured questionnaires from March 27th to April 17th, 2015 and analyzed using descriptive statistics, t-test, one way ANOVA, Pearson's correlation and multiple regression with SPSS 21.0 program. As a result, the level of attitude of patient safety was 3.68 score and PSMA was 4.03 score. In PSMA, there were significant differences in practice period(p=.020) and practice satisfaction(p=.026). There was a positive correlation(p<.001) among attitude of patient safety and PSMA. The most effective factor on PSMA was practice satisfaction, followed by attitude of patient safety. Based on the findings of this study, suggest that to develop the systematic education program considering effective factors of PSMA for nursing students.

• Quality Improvement in Health Care
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• v.5 no.1
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• pp.42-57
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• 1998

Background : It is increasing the concern for patient satisfaction as a customer information. This study was planned to investigate the activities related to patient satisfaction survey at the Korean hospitals. Methods : We performed the nationwide survey on 235 general hospitals by using the self-administrated checklist from Sep. 9 to Oct. 9, 1996. The response rate were 50.2%. We analyzed the descriptive statistics and chi-square test by SAS software on 118 hospitals. Results : First of all, 62.7% of study hospitals showed to conduct the patient satisfaction survey, and most of hospitals which did not conduct it had a plan to do it within 5 years. The reason that hospitals did not conduct satisfaction survey was due to a lack of administrator's interest or adequate questionnaire form. Second, the bigger, public and being more located in the big city or opened more than 10 years, the more hospitals conducted the patient satisfaction survey. Also, patient satisfaction survey was mainly handled by planning dept. or administrative team. Third, most hospitals had their own way of making questionnaires without proving reliability and validity. The results of the survey were applied to hospital management timely, and were mostly reported to top manager level. Most CEO concerned about the results of satisfaction survey. Fourth, the staffs in charge of survey had problems such as skill related to data analysis and development of questionnaire and they suggested that this problems could be solved through inducing the implementation of the survey results on hospital management, support for the development of standardized questionnaires and increasing the top manager's interests. Fifth, most questionnaires composed of lots of questioning items on hospital equipments and environment, and kindness of hospital employee to patients. Conclusions : Although this study had some limitations in generalization due to low response rate in big hospitals, it is meaningful to find the present state and the problems related to patient satisfaction survey of the general hospitals. We can conclude that there are increasing the concern for patient satisfaction survey among the hospitals nationwide, and it can be needed for technical support related to development of survey tool or method.

• Journal of Korean Academy of Nursing
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• v.36 no.4
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• pp.596-603
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• 2006

Purpose. This study examined Korean clinical nurses' intentions to care for SARS patients and identify determinants of the intentions. Theory of planned behavior was the framework to explain the intentions of Korean nurses for SARS patients care. Methods. A convenient sample of six hundreds and seventy nine clinical nurses from four university-affiliated hospitals located in Seoul and in Kyung-gi province was used. Self-administered (83-items) questionnaire was used to collect data. Intentions, attitude, subjective norm, perceive behavioral control, behavioral beliefs, normative beliefs, and control beliefs were the study variables. All items were measured using 7point Likert scale (-3 to +3). Data were analyzed using descriptive statistics, Pearson correlation method, and stepwise multiple regression methods. Results. Intentions and attitudes toward SARS patient care among Korean clinical nurses were moderate, but their subjective norm and perceive behavioral control of SARS patients care were negative. Stepwise multiple regression analysis indicated that attitude toward SARS patient care, perceived behavioral control, subjective norm were the determinants of the intentions for SARS patients care as theory proposed. Among the behavioral beliefs, 'SARS-patient caring would be a new experience', 'during SARS-patient caring, I should be apart from my family', 'after completing SARS-patient caring, I would be proud of myself being able to cope with a stressful event' and 'with my SARS-patient caring, patients could recover from SARS' were the significant determinants. Among the normative beliefs, colleague approval, spouse approval, and physician approval were significant determinants of the intentions. Among the control beliefs, 'SARS-patient caring would be a challenge' 'SARS-patient caring is a professional responsibility', 'tension during the care of SARS patients' and 'support from team members' were the significant determinants of the intentions. Conclusions. Korean clinical nurses in this study were not willing to care for SARS patients and showed negative attitude toward the care. They believed their friends and family were not approved their care for SARS patients. Nurses were in conflicts between professional responsibilities to care for SARS patients and personal safety. This study was the first to understand stress and burden of Korean clinical nurses who are in front line to care for newly developed communicable disease such as SARS. Under the circumstance where several fatal communicable diseases are predictable, conflicts between professional responsibility and their personal risks should be taken into considerations by nurses themselves and by nursing administrators in order to improve quality of care.

• Journal of Digital Convergence
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• v.13 no.4
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• pp.227-233
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• 2015

The recent health care is growing rapidly want to receive offers users a variety of medical services, can be exploited easily exposed to a third party information on the role of the patient's hospital staff (doctors, nurses, pharmacists, etc.) depending on the patient clearly may have to be classified. In this paper, in order to ensure safe use by third parties in the health care environment, classify the attributes of patient information and patient privacy protection technique using hierarchical multi-property rights proposed to classify information according to the role of patient hospital officials The. Hospital patients and to prevent the proposed method is represented by a mathematical model, the information (the data consumer, time, sensor, an object, duty, and the delegation circumstances, and so on) the privacy attribute of a patient from being exploited illegally patient information from a third party the prevention of the leakage of the privacy information of the patient in synchronization with the attribute information between the parties.

• Journal of Korean Academy of Nursing
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• v.26 no.3
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• pp.688-696
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• 1996

The purpose of this study was to investigate the fluid balance of the patients who were either on soft fluid diet or total parenteral nutrition. We studied 19 patients with neurologic disorders and 22 patients with oromaxillary surgery who were admitted to either D university hospital in Choognam or S general hospital in Seoul between May and November 1995. The mean age for the patients who had oromaxillary surgery was 24 years and their average hospital stay was 9 days. The mean age of the patients with neurologic disorders was 54 years and they were bedridden for average of 71 days. For the maxillary bone surgery patients we did not limit the range of their activities in the ward during data collection period. The patients with neurological disorders were bedridden and did not move around the ward. They were all either on soft fluid diet, or total parenteral nutrition. The findings of this study are as follows ; 1) The difference of the triceps skinfold thickness between the baseline and the final measurement was 0.4cm for neurologic patient group and 0.5cm for oromaxillary surgery patient group. The difference was not statistically significant in each group. 2) In the oromaxillary surgery patient group, the daily intake of fluid in the form of pure water, other beverages, fluid diet as well as IV fluid was 4581m1 while urine output was 2979ml. The difference between fluid intake and output was statistically significant, indicating that fluid intake was far more than urine output. In neurologic patient group, the daily intake of fluid including water from fluid diet and IV fluid was 2701m1 whereas urine output was 2253m1 and they were statistically significant. 3) For a more accurate assessment we adjusted the fluid balance based on weight changes during data collection period. In the oromaxillary surgery patient group. the difference between fluid intake and output was 1238m1 after weight changes being adjusted. The difference was statistically significant, suggesting fluid overload in this patient group. In neurologic patient group, the difference between fluid intake and output considering weight changes was 124ml. The difference was not statistically significant, suggesting that the fluid intake and output was well balanced in this patient group.